The use of anti-angiogenic agents, especially bevacizumab, is now validated in non-small lung cancers and may be of interest in small cell lung cancer. The safety profile of these agents is not trivial and patient selection must be rigorous. We still lack predictive factors which could allow a decrease the overall toxicity of these agents through selection of the patients who would take the largest advantage of these treatments. Functional imaging could represent a valuable tool for early evaluation of their activity, but it remains to be evaluated. Numerous questions remain unsolved, such as the optimal treatment sequence respective to classical agents, their long-term toxicity and their use in the adjuvant setting.